Hormones and Sleep: Why Menopause Affects Your Rest—and How to Fix It

There’s no doubt that menopause brings big changes—physically, mentally, and emotionally. One of the most common concerns I hear from women in this phase of life? Sleep problems. Maybe you’ve always been a great sleeper and are now plagued by insomnia or hot flashes that jolt you awake at 3 a.m. Or perhaps you’ve struggled with sleep for years, and menopause has only made things worse. The good news? There are solutions.

While shifting hormones can make sleep more elusive, your need for it is just as vital as ever. Poor sleep can make everything feel harder to manage. It affects mood, memory, energy levels, and can worsen many common menopause symptoms—like stress, depression, and physical discomfort.

Much of this is driven by declining levels of estrogen and progesterone, which begin to dip in the mid-40s (or even earlier for some women). Melatonin, our body’s natural sleep hormone, also decreases with age—and it’s indirectly supported by estrogen. On top of that, stress (which tends to rise in perimenopause) can further deplete melatonin. While menopause is a universal experience, there’s no denying it can be a real challenge—especially when it comes to getting good rest.

Sleep is foundational for overall health. Beyond irritability and sugar or caffeine cravings, long-term sleep deprivation can contribute to weight gain, increased inflammation, elevated blood pressure and blood sugar, headaches, and cognitive issues. For women with chronic pain conditions, poor sleep often amplifies discomfort.

Thankfully, there are many ways to support more restful sleep. Sleep hygiene remains the cornerstone—simple shifts like a 15-minute guided meditation, a warm Epsom salt bath, or limiting screen time before bed can make a big difference. Herbal teas, calming nighttime routines, and aromatherapy are other easy-to-implement strategies.

When lifestyle adjustments aren't enough, some women benefit from gentle herbal supplements like ashwagandha, passionflower, or valerian root. And with lab testing, we can uncover imbalances in key hormones—such as elevated cortisol or low estrogen—that may be standing in the way of better sleep. By addressing these with targeted lifestyle changes, supplements, and in some cases, bio-identical hormone replacement therapy (BHRT), many women experience not only deeper sleep but also more stable moods, sharper cognition, and improved overall well-being.

If you’re navigating sleep struggles in perimenopause or menopause, you’re not alone—and you don’t have to suffer through it. With the right support, better sleep is absolutely within reach.